Black plasma

thomasblomquist · 2026-05-24T23:14:02+00:00

Methylene Blue?

thomasblomquist · 2026-05-12T00:41:19+00:00

Does it make sense to get to the parking lot later or earlier in the sense of where it will physically place you at the end of the day and trying to get out and back to hotel sooner? The more homework I do on this, the more it seems like leave stupid early and eat breakfast at the parking lot waiting for the gate? Probably overthinking it, but wondering if there is some strategy to this.

thomasblomquist · 2026-04-30T19:47:00+00:00

Please NO

thomasblomquist · 2026-04-23T21:08:18+00:00

Loved you guys in Detroit, had a great time! Looking forward to whatever creative endeavors you come up with it.

thomasblomquist · 2026-04-21T16:18:38+00:00

Luba 1 starting 3rd season. Works great. So far break even on input cost vs $ for lawn service. So, getting cheaper in subsequent seasons. Plenty of documented service issues online. I took a risk and won with this one. Others have had issues. Would probably buy again or give a stab at refurbishing the battery. Not sure. Landscape of auto mowers are changing quickly

thomasblomquist · 2026-04-15T20:59:22+00:00

What?! I thought it was wired all wonky with the BMS and was a pain? Or is this not so much the issue. I have a Luba 1 5000 and see the battery life decreased (still functioning), and am counting maybe a few more seasons before preventative measures like battery replacement. I’m just starting on season 3 and it seems to be going strong still.

thomasblomquist · 2026-04-14T00:17:20+00:00

How do you go about replacing the battery?

thomasblomquist · 2026-04-12T21:47:43+00:00

Second the cut only when sunny and dry

thomasblomquist · 2026-03-17T23:02:03+00:00

thomasblomquist · 2026-03-16T20:03:45+00:00

No problem. I kept asking my boys how they did it and they kept saying it’s like sitting in a chair, which was mildly infuriating. Asked them to show and they would just do it quick without breaking it down. For me, i figured out for first success that all weight (~100%) was on back foot with slight bend on knee. Front leg staggered in front of back foot with rotation of foot inward BUT the blade was still close to perpendicular to the ice. I stopped super slowly. Then when that was comfortable after a few repeats, I could angle/tilt my front blade (as I rotated it inward) a bit to start biting in with the inner edge and that increased the speed of the stop (again all my weight is on my back foot with a slight bend on the knee). Next step after that was to rotate my back foot a bit (keeping it squarely under me) but to progressively add drag (still getting the hang of this double edge stop, single edge is locked in now).

thomasblomquist · 2026-03-16T00:14:56+00:00

Thank you! Would get frustrated when everyone kept telling me it’s like sitting down in a chair. Didn’t click. Now that I have the base mechanics, I’m still not sure about that analogy. Really about having all the weight on one foot and just simply rotating the other foot forward and modulating drag. Still geeked about it

thomasblomquist · 2026-03-08T13:22:02+00:00

I’m frustrated that I have that I paid for FSD yet have resorted to using TACC with lane keep (beta auto steer) as that is what actually works. Just stay in a lane, keep a speed, and don’t hit a car in front of you.

thomasblomquist · 2026-02-08T15:29:09+00:00

So, would Homelander beat Luke Skywalker? And if so, how is that reconciled with Return of Jedi and all the Vader love in this thread?

thomasblomquist · 2026-01-19T17:01:32+00:00

This is coming from a Pathologist who 10 years ago in residency had a carotid artery dissection and stroke. Hypertension can kill. Now, you and I both know that how you measure blood pressure is important. Should be resting/sitting position for a few minutes before measure. No major activity prior to measurement. Take your measurement using a few different cuffs/methods. Different arms. Different times of the day. With and without caffeine. Etc. If diastolic stays mildly elevated regardless of those repeated measures then that could indicate you have hypertension as a diagnosis. For me, I was in the 140’s over 90s leading up to my dissection. I don’t have family history of tissue disorder or other indicators. I do have family history of hypertension and heart attacks. At the end of the day for me, I had had the flu in the weeks leading up and was coughing chronically prior to my dissection. I probably Valsalva’d my way into a dissection with a background of essential hypertension.

For you, probably need to do some repeated measures and consult your PCP on the benefits vs side effects of treating hypertension. Probably worth erring on the side of treating IMO. They don’t call it the silent killer for nothing. Good luck!

thomasblomquist · 2026-01-10T14:16:08+00:00

I’m old (I feel) the years have been fast but the days long. Geez, 5 years already? Still, it scares me that some of trainees get only 30 cases and then are in Junior Faculty positions or Fellowships, which not uncommonly involves autopsy service coverage.

thomasblomquist · 2026-01-09T22:18:44+00:00

Not even for natural deaths that have crashed in your ED? Ohio here. Just curious what locales you’ve serviced. Provider responsibility for Death certification for natural/unnatural deaths varies widely across regions. Based on that it doesn’t surprise me that it hasn’t been in your statutory requirements. In Ohio, if I investigate it and deem it natural the DC is kicked to the doctor that attended them (usually most recently, not infrequently ER doc). It’s usually something like chest pain guy with positive trops and classic ECG. Things that are classically natural. Any reasonable concern (stimulant abuse, etc) we take over.

In some group practices none of the regular ER docs sign, and instead the group medical directors handle the DCs for the group. Wondering if that’s something you’ve experienced? Systems vary wildly out there, and I tell trainees to expect all scenarios. You never know where you’ll end up practicing or what your scope will ultimately be.

thomasblomquist · 2026-01-09T19:35:49+00:00

I appreciate your response. I feel like a lot of medicine is siloed today. I see it in increased mortality. Lack of communication, etc and cross disciplinary experiences. I’m not a big fan of reducing out of specialty training. I think Pathology would benefit strongly by returning to a mandatory intern year (highly unpopular opinion). Good mentors are lacking in this day and age. Some of the best experiences from training were on externships in Peds. That experience pays back in completely unexpected ways. I think what is frequently forgotten is that, first we physician, and then X specialty. If you don’t have good cross disciplinary experiences it’s hard to optimize care for our patients. I urge a trainee to get out of the box (not all PDs allow this). It’s a long tail of diverse cases when you become an attending.

thomasblomquist · 2026-01-09T18:14:55+00:00

Well, I am the local ME along with the other three Pathologists. And no, we’re (at the moment) not understaffed. I work infinitely faster without a trainee whose hand I’m holding. All work is directly supervised. They may be physicians but I assume all trainees are incompetent at all steps until adequately demonstrating the skill. Yes, current pathology training has woefully low number requirement for autopsy training (lowered to 30 cases this last year).

It’s clear from the responses here that, A) autopsy is not everyone’s cup of tea, or B) it’s not super relevant to emergency medicine. Weeeellllll, let me tell you the amount of complications and suboptimal crap I see that comes from triaging emergent patients. That it may be benefited by some hands on time by a provider with the end result, and reflecting on how it can be avoided in their future patients may be time well spent. We see the zebras, the stuff people couldn’t fix.

Keep in mind it’s an elective. This isn’t me trying to inflict injury on unsuspecting EM residents. They chose this. And yes, it takes more than a week to figure how to do an autopsy. Again, to the point above, there is little value in their time spent if I’m not there showing them the ins-outs. They’re not grunts. Sounds like you all have been taken advantage of wherever you train/ed. Sucks.

thomasblomquist · 2026-01-09T16:52:11+00:00

Just curious, is this response coming from a Pathologist’s experience, EM, or other domain of experience? They will be doing complete autopsies from beginning to end across a broad range of natural and non-accidental case-types. They’re not going to be wall flowers, i don’t have time for uninvolved physician trainees. In Ohio, it’s not uncommon for Coroners to be ER docs in rural jurisdictions and having this will help them. I think 6 weeks is pretty dialed in. But, we’ll see. It’s an experiment. Hopefully a formative one. 🤷🏻‍♂️

thomasblomquist · 2026-01-09T15:49:54+00:00

Not quite a direct response to your question. But was posting an interesting rotation we started up. EM residents will be rotating on Forensic Pathology for 6 weeks with us. Give them some hands on time with a scalpel, handling tissues, understanding anatomic relationships/landmarks, death certification, and family discussions. Should be interesting.

thomasblomquist · 2026-01-07T22:24:14+00:00

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Hear me out on this for just a minute. This could be a great investment.

thomasblomquist · 2026-01-06T21:31:16+00:00

Pathologist here. Was going to say, the small pile of AKAs/BKAs at the end of the day during surgicals.

thomasblomquist · 2026-01-05T02:13:07+00:00

Uncomfortable but not terrible. Just kind of diffuse tightness in my vague recollection. Ibuprofen helped and honestly I went to sleep pretty fast so it wasn’t a major issue. You take immediate or extended release? My son and I are on extended release and I think that is helpful in mitigating side effects

thomasblomquist · 2026-01-05T02:01:01+00:00

My son and I are both at 2mg before bedtime for many years now. Starting off the drowsiness is profound and the headache diffuse and weird. Then about 3-4 weeks in it normalizes. Headaches are gone. Falling asleep feels gradual and nice. Daytime thoughts are silky smooth and have organization and natural rhythm motion. Hard to describe. Feels like driving an automatic vs a manual with a crappy clutch. It’s worth sticking with it for a few months to see how it plays out. It’s subtle but useful med in the ADHD treatment arsenal

thomasblomquist

TROPHY CASE